In our previous paper on the Future of Cognitive Remediation published more than 10 years ago, we envisaged an imminent and wide implementation of cognitive remediation therapies into mental health services. This optimism was misplaced. Despite evidence of the benefits, costs, and savings of this intervention, access is still sparse. The therapy has made its way into some treatment guidance, but these documents weight the same evidence very differently, causing confusion, and do not consider barriers to implementation. This paper revisits our previous agenda and describes how some challenges were overcome but some remain. The scientific community, with its commitment to Open Science, has produced promising sets of empirical data to explore the mechanisms of treatment action. This same community needs to understand the specific and nonspecific effects of cognitive remediation if we are to provide a formulation-based approach that can be widely implemented. In the last 10 years we have learned that cognitive remediation is not “brain training” but is a holistic therapy that involves an active therapist providing motivation support, and who helps to mitigate the impact of cognitive difficulties through metacognition to develop awareness of cognitive approaches to problems. We conclude that, of course, more research is needed but, in addition and perhaps more importantly at this stage, we need more public and health professionals’ understanding of the benefits of this therapy to inform and include this approach as part of treatment regimens.

中文翻译：

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重新思考认知矫正疗法的未来：在患者获得治疗之前还需要解决什么问题？


在我们 10 多年前发表的上一篇关于认知矫正未来的论文中，我们设想了即将将认知矫正疗法广泛实施到心理健康服务中。这种乐观是错误的。尽管有证据表明这种干预的好处、成本和节省，但访问仍然很少。该疗法已进入一些治疗指南，但这些文件对相同证据的权重非常不同，造成混淆，并且没有考虑实施的障碍。本文重新审视了我们之前的议程，并描述了如何克服一些挑战，但仍然存在一些挑战。科学界致力于开放科学，已经产生了有前途的实证数据集来探索治疗作用的机制。如果我们要提供一种可以广泛实施的基于公式的方法，那么同一个社区需要了解认知矫正的特异性和非特异性影响。在过去的 10 年里，我们了解到认知矫正不是“大脑训练”，而是一种整体疗法，涉及积极的治疗师提供动机支持，并通过元认知帮助减轻认知困难的影响，以培养对解决问题的认知方法的认识。我们得出的结论是，当然还需要更多的研究，但除此之外，也许更重要的是，在这个阶段，我们需要更多的公众和卫生专业人员对这种疗法的好处的了解，以便为这种方法提供信息并将其作为治疗方案的一部分。